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102. Ct-guided bone biopsy in cancer patients with suspected bone metastases: retrospective review of 308 procedures

Author

Monfardini, L, Preda, L, Aurilio, G, Rizzo, S, Bagnardi, V, Renne, G, Maccagnoni, S, Vigna, P, Davide, D, Bellomi, M, Bellomi, M., BAGNARDI, VINCENZO, Monfardini, L, Preda, L, Aurilio, G, Rizzo, S, Bagnardi, V, Renne, G, Maccagnoni, S, Vigna, P, Davide, D, Bellomi, M, Bellomi, M., and BAGNARDI, VINCENZO

Abstract

Purpose The authors assessed the adequacy and sensitivity of CT-guided bone biopsy in 308 procedures performed in 286 cancer patients with suspected bone metastases. Materials and methods An electronic search of our CT-guided bone biopsy database was retrospectively performed to evaluate the adequacy of samples and, in the event of negative samples, whether the patients had radiological progression at the site of biopsy (false negative). Adequacy and false-negative rate were compared with radiological features, biopsy location, specimen length and complications to assess any statistically relevant association with a multivariate logistic regression model. Results A total of 290/308 (94.1 %) samples were adequate. Forty-five patients had normal bone marrow and were followed-up, with evidence of progression at the site of biopsy in 10 cases (false-negative cases); overall sensitivity was 96.7 %. Specimen length was significantly correlated to the probability of an adequate biopsy (p = 0.035) and inversely correlated to the probability to obtain a false-negative result (p = 0.02). We encountered 11/308 (3.5 %) minor complications and no major complications. Conclusion CT-guided biopsy of bone lesions in cancer patients allows for a final diagnosis in 94 % of cases. A specimen longer than 1 cm may lead to a significant result in terms of adequacy and sensitivity. Negative biopsies with positive positron emission tomography or magnetic resonance imaging and specimen shorter than 1 cm should be repeated to avoid a false-negative result. © 2014 Italian Society of Medical Radiology.

Published
2014

103. Strahleninduzierte akute Dysphagie : Prospektive Beobachtungsstudie an 42 Kopf-Hals-Malignompatienten.

Author

Alterio, D., Gerardi, M., Cella, L., Spoto, R., Zurlo, V., Sabbatini, A., Fodor, C., D'Avino, V., Conson, M., Valoriani, F., Ciardo, D., Pacelli, R., Ferrari, A., Maisonneuve, P., Preda, L., Bruschini, R., Cossu Rocca, M., Rondi, E., Colangione, S., and Palma, G.

Subjects
OTOLARYNGOLOGY, DEGLUTITION, DEGLUTITION disorders, ENTERAL feeding, ESOPHAGUS, GASTROSTOMY, LONGITUDINAL method, PSYCHOLOGICAL tests, RADIATION doses, RADIATION injuries, SQUAMOUS cell carcinoma, STATISTICS, TUMORS, PHARYNGEAL muscles, THERAPEUTICS, RADIOTHERAPY
Abstract

Copyright of Strahlentherapie und Onkologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2017
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105. Discordant hormone receptor and human epidermal growth factor receptor 2 status in bone metastases compared to primary breast cancer

Author

Aurilio, G, Monfardini, L, Rizzo, S, Sciandivasci, A, Preda, L, Bagnardi, V, Disalvatore, D, Pruneri, G, Munzone, E, Della Vigna, P, Renne, G, Bellomi, M, Curigliano, G, Goldhirsch, A, Nolè, F, BAGNARDI, VINCENZO, Nolè, F., Aurilio, G, Monfardini, L, Rizzo, S, Sciandivasci, A, Preda, L, Bagnardi, V, Disalvatore, D, Pruneri, G, Munzone, E, Della Vigna, P, Renne, G, Bellomi, M, Curigliano, G, Goldhirsch, A, Nolè, F, BAGNARDI, VINCENZO, and Nolè, F.

Abstract

Background. In patients with metastatic breast cancer, the evaluation of the biological characteristics of metastatic bone deposits may be a valuable adjunct in clinical practice. We assessed the discordance in expression levels for estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2) between primary tumor and bone metastases and its clinical impact on patient management. Material and methods. We retrospectively reviewed 363 CT-guided bone biopsies performed from January 1997 to December 2009. The proportions of ER, PgR and HER2 positive tumors at primary diagnosis and bone metastases, determined by IHC and/or FISH, were compared using McNemar's test. The impact of the biopsy reassessment on treatment choice was evaluated with Fisher's exact test. Results. We selected 109 metastatic breast cancer patients with histologically confirmed bone metastases. Among 107 assessable patients the overall discordance rate was detected in 22 (20.5%) and in 47 (43.9%) patients for ER and PgR, respectively, and in six of 86 assessable patients (6.9%) for HER2 status. The indication to change endocrine therapy occurred in 62% and 30% of patients with ER discordance and ER concordance, respectively (p = 0.01). The indication to change targeted therapy occurred in 67% and 8% of patients with HER2 discordance and HER2 concordance, respectively (p = 0.002). Conclusions. We confirm that biopsy of metastases, including bone metastases, for reassessment of biology should be considered, since it is likely to impact on treatment choice.

Published
2013

115. Abstract P1-13-03: Is Bone Biopsy of Metastatic Sites Useful in Advanced Breast Cancer Management?

Author

Aurilio, G, primary, Sciandivasci, A, additional, Bagnardi, V, additional, Della Vigna, P, additional, Monfardini, L, additional, Preda, L, additional, Rizzo, S, additional, Padrenostro, M, additional, Renne, G, additional, Munzone, E, additional, Cullurà, D, additional, Petrella, MC, additional, Bellomi, M, additional, and Nolè, F., additional

Published
2010
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139. High-dose chemotherapy in relapsed or refractory Hodgkin lymphoma patients: a reappraisal of prognostic factors.

Author

Cocorocchio, E, Peccatori, F, Vanazzi, A, Piperno, G, Calabrese, L, Botteri, E, Travaini, L, Preda, L, and Martinelli, G

Abstract

High-dose chemotherapy (HDCT) has a consolidated role in the treatment of patients with refractory or relapsed Hodgkin lymphoma (HL). We report clinical results of 97 HL patients who underwent HDCT for refractory (62 patients) or relapsed (35 patients) diseases in Istituto Europeo di Oncologia, from 1995 to 2009. Treatment included high-dose carmustine, etoposide, cytarabine and melphalan in 84 patients and high-dose idarubicin and melphalan in 13 patients with subsequent peripheral hemopoietic stem cells transplant. Outcomes were evaluated in terms of progression-free survival (PFS) and overall survival (OS). In order to identify prognostic factors for outcome, a multivariate analysis for age, sex, disease status (refractory/relapsed), disease stage, B symptoms, presence of extranodal involvement, bulky disease, elevated lactate dehydrogenase, number of previous chemotherapy lines, remission status before transplant, 18F-fluoro-deoxy-d-glucose positron emission tomography ((18) FDG-PET) status before and after transplant was done. A clinical response was achieved in 91% of patients, with complete remissions in 76/97 patients. With a median follow-up of 45 months (range 1-164 months), 5-year PFS and OS were 64% and 71%, respectively. Remission status after induction therapy, 18F-fluoro-deoxy-d-glucose positron emission tomography status before and after transplant were the most important prognostic factors for PFS and OS in univariate or multivariate analyses. HDCT is able to induce a high remission rate and a prolonged PFS in more than 50% of the patients with refractory and relapsed HL. [ABSTRACT FROM AUTHOR]

Published
2013
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143. Effect on renal function of an iso-osmolar contrast agent in patients with monoclonal gammopathies.

Author

Preda L, Agazzi A, Raimondi S, Lanfranchi CF, Passerini R, Calvetta A, Martinelli G, Bellomi M, Preda, Lorenzo, Agazzi, Alberto, Raimondi, Sara, Lanfranchi, Carla Federica, Passerini, Rita, Calvetta, Albania, Martinelli, Giovanni, and Bellomi, Massimo

Abstract

Objective: To assess the safety of the non-ionic iso-osmolar contrast agent iodixanol on renal function in patients with monoclonal gammopathies undergoing CT.Methods: We explored the effect of iodixanol on renal function in 30 patients with monoclonal gammopathies and 20 oncological patients with a normal electrophoretic profile (control group). The parameters used to estimate renal function were: serum creatinine, eGFR (determined 24 h before and 48 h after the administration of iodixanol), and urinary excretion of Neutrophil Gelatinase-Associated Lipocalin (NGAL) determined 2 h and 24 h after. Serum creatinine was also determined 1 month after the administration of iodixanol.Results: No significant increase in serum creatinine values were observed in the monoclonal gammopathies group and in 19/20 patients in the control group. Only 1 patient in the control group developed a transient contrast agent-induced nephropathy. We found no statistically significant difference between the two groups regarding the percentage variation from baseline values of serum creatinine, creatinine clearance, NGAL 2 h after, and eGFR. Whereas NGAL at 24 h showed a statistically significant increase in patients with Monoclonal gammopathies.Conclusion: The use of iodixanol appears to be safe in patients with monoclonal gammopathies and an eGFR≥ 60 ml/min/1.73 mq. [ABSTRACT FROM AUTHOR]

Published
2011
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144. US-guided transcutaneous tru-cut biopsy of laryngo-hypopharyngeal lesions.

Author

Preda L, De Fiori E, Rampinelli C, Ansarin M, Petralia G, Maffini F, Alterio D, Bonello L, Chiesa F, Bellomi M, Preda, Lorenzo, De Fiori, Elvio, Rampinelli, Cristiano, Ansarin, Mohssen, Petralia, Giuseppe, Maffini, Fausto, Alterio, Daniela, Bonello, Luke, Chiesa, Fausto, and Bellomi, Massimo

Abstract

Objective: To evaluate the feasibility and performance of ultrasound-guided transcutaneous tru-cut biopsy (USGTCB) in selected patients (with stenosis of airways or difficult intubation or contraindication to general anaesthesia) with untreated or previously treated suspicious laryngo-hypopharyngeal masses.Methods: Biopsies were performed with a free-hand technique by a single radiologist. Thirty-six USGTCBs were scheduled in 34 patients (24 males, 10 females; age range 47-95 years). Two USGTCBs were not performed, as lesions were not detectable: therefore, 16 USGTCBs were performed for an untreated mass suspicious for malignancy and 18 were performed for a mass suspicious for recurrence after radiotherapy alone, or associated with endoscopic laser surgery or chemotherapy.Results: USGTCB diagnosed 25 squamous cell carcinomas (73.5%) and nine benign lesions (26.5%); no false positives and two false negatives were reported, both in patients previously treated with radiotherapy. The sensitivity, specificity, positive and negative predictive value of the technique was 92.5%, 100%, 100% and 77.7% respectively, with no major complications.Conclusion: Although biopsy under microlaryngoscopy remains the "gold-standard" technique, USGTCB is feasible, carries the advantages of avoiding general anaesthesia, is suitable for outpatients and is cost-effective. If applied to selected patients, it could be considered for the histological diagnosis of both primary and recurrent laryngo-hypopharyngeal masses. [ABSTRACT FROM AUTHOR]

Published
2010
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